16 AUGUST 2019 VOLUME 20 ISSUE 31

Media Coverage

• Ebola Could Be Eradicated — But Only if the World Works Together

  The global health community got a few pieces of hopeful news this week. On Monday the World Health Organization announced that two newly developed intravenous drug therapies appear capable of curing Ebola. Then, on Wednesday, the Food and Drug Administration effectively endorsed a three-drug treatment that appears to cure so-called extensively drug-resistant tuberculosis — the deadliest version of the world’s deadliest infectious disease. Together, these developments could mark a pivotal moment in the century-long quest for global health security.

  August 16, 2019

  General

  New York Times

• A Tissue Sample From 1966 Held Traces of Early HIV

  In 1966, a 38-year-old man visited a hospital in what is now the Democratic Republic of Congo. His name, his symptoms, and everything about him beyond his age and gender have been lost to history. But a piece of one of his lymph nodes was collected and preserved. By analyzing it, a team of researchers led by Michael Worobey from the University of Arizona have shown that the man was infected by HIV, the virus that causes AIDS. He wouldn’t have known it, though, and nor would his doctors. HIV was formally discovered 17 years later.

  August 16, 2019

  General

  The Atlantic

• STI Rate in Women on Birth Control High: Study

  Kenyan women on long-acting contraceptives recorded higher rates of sexually transmitted infections, compared to the general population, a new study reveals.

  August 15, 2019

  Hormonal Contraceptives and HIV

  Daily Nation

• Zimbabwe: New Drug Offers Better Prospects in HIV Fight

  Zimbabwe has just started a national roll-out of the new antiretroviral drug, Dolutegravir (DTG), which is set to gradually wean off Tenolam E.

  August 14, 2019

  Treatment

  All Africa

• People Getting PrEP at Their Clinic Have More STI and HIV Tests Than People Who Buy It Online

  The third in an annual series of UK surveys conducted by Public Health England in collaboration with PrEPster and iwantPrEPnow (IWPN) reports that although the proportion of people who have ever used HIV pre-exposure prophylaxis (PrEP) has not increased since the previous survey, a higher proportion report currently using PrEP.

  August 14, 2019

  PrEP

  aidsmap

• ‘Scandal’ As UK Gay Men at Risk Without Access to HIV Prevention Pill

  Delays in rolling out an HIV prevention pill in Britain are putting gay men’s lives at risk, with thousands buying it online without medical supervision, HIV campaigners said on Wednesday.

  August 14, 2019

  PrEP

  Reuters

• Gilead’s New Drug Descovy Spotlights Old Cracks in HIV Care

  Even as the science around HIV treatment and prevention moves forward at a brisk pace, much of the public image around the disease and who’s at risk remains static. That problem is exacerbated by clinical studies for HIV drugs that don’t accurately reflect the populations that need them.

  August 14, 2019

  PrEP

  Bloomberg Law

• All Clinicians Have Unforgettable Patients: This One Has HIV

  Nelly Mugo, MB ChB, from the Kenya Medical Research Institute and the University of Washington in Seattle, was counseling a woman about her recent HIV diagnosis when the patient caught her off guard. "I came to you guys 2 years ago and had a baby," she recalls her patient saying. Mugo's colleagues at the maternity wing of an urban hospital in Nairobi helped deliver the woman's baby. "I was negative. Nobody told me that I was at risk for getting HIV."

  August 14, 2019

  Hormonal Contraceptives and HIV, Treatment

  Medscape

• Scientists Discover New Cure for the Deadliest Strain of Tuberculosis

  When she joined a trial of new tuberculosis drugs, the dying young woman weighed just 57 pounds. Stricken with a deadly strain of the disease, she was mortally terrified. Local nurses told her the Johannesburg hospital to which she must be transferred was very far away — and infested with vervet monkeys.

  August 14, 2019

  General

  New York Times

• Winnie Byanyima Chosen to Lead UNAIDS

  Winnie Byanyima will soon take the helm of UNAIDS as its new executive director, it was announced Wednesday, concluding a months-long selection process to find a new leader for the embattled agency.

  August 14, 2019

  General

  Devex

• NHVMAS Seeks Policy Change on Sexual Reproductive Health

  HIV Vaccine and Advocacy Society, NHVMAS, has urged the Federal government to embrace a policy change on adolescents’ age of access to Sexual Reproductive Health, SRH and HIV services to 14 years. The Society who made the call during a media roundtable on ‘adolescents’ sexual reproductive health and age of consent said policy change would ensure that the age of maturity at 18 years will not constitute a barrier in accessing services.

  August 13, 2019

  General

  Vanguard

• HIV Prevention Drugs Could Become As Accessible As Decongestants

  California lawmakers are working to make PrEP and PEP available as over-the-counter drugs without a prescription, reports Capital Public Radio. The legislation would authorize pharmacists to provide PrEP and PEP without a prescription, much like birth control pills are currently available in the Golden State.

  August 12, 2019

  PrEP

  Instinct Magazine

• Preclinical Trial of TDF Vaginal Ring for PrEP Ends Early

  A preclinical trial of a tenofovir disoproxil fumarate (TDF) intravaginal ring for HIV pre-exposure prophylaxis ended early after 8 of 12 women unexpectedly developed vaginal ulcers.

  August 12, 2019

  Microbicides

  Contagion Live

• Chlamydia Vaccine Moves a Step Closer

  A vaccine to protect against chlamydia has moved closer to becoming reality after a pioneering clinical trial found the treatment to be safe. The vaccine successfully provoked an immune response, boosting levels of antibodies against the chlamydia bacterium in the blood and vaginal fluids.

  August 12, 2019

  General

  The Guardian

• Cash Payments to Stay in School Reduce HIV Incidence in Girls and Young Women, eSwatini Study Finds

  Financial incentives to remain in school reduced HIV incidence among adolescent girls and young women in eSwatini (Swaziland) by 21 percent, and participants exposed to both financial incentives and a lottery open only to those who remained free of sexually transmitted infections (STIs) were 37 percent less likely to acquire HIV infection, a trial has found.

  August 12, 2019

  General

  aidsmap

• Antiretroviral Therapy’s Positive Impact on Global Public Health Faces Challenges Moving Forward

  Since the introduction of azidothymidine in 1987 there have been major improvements in the treatment of HIV. In a recently published study, Forsythe and colleagues demonstrate that the advent of antiretroviral therapy (ART) in the mid 1990s has yielded significant achievements in global public health. Between 1995 and 2015, 9.5 million deaths have been averted worldwide, and global economic benefits are estimated at over $1 trillion.

  August 12, 2019

  General

  Forbes

• A Cure for Ebola? Two New Treatments Prove Highly Effective in Congo

  In a development that transforms the fight against Ebola, two experimental treatments are working so well that they will now be offered to all patients in the Democratic Republic of Congo, scientists announced on Monday.

  August 12, 2019

  General

  New York Times

• Potential New PrEP Drug Exposes Gaps in Data for Women

  Among all the CAR-T commotion you may have missed it: An FDA panel on Wednesday recommended Gilead’s Descovy to block HIV transmission in men and transgender women, a step toward another PrEP finally coming to market (the sole medicine right now being Gilead’s Truvada). One potential snag — the advisory committee narrowly voted not to recommend the medicine, which is already approved to treat HIV, for women who are not transgender, also referred to as cisgender women.

  August 9, 2019

  PrEP

  Politico

• Trump HIV Plan, Gilead Donation Spur Health Center Concerns

  Gilead Sciences Inc.'s donation of enough of its drug Truvada to treat 200,000 people for 10 years comes with some concerns for community health centers that say that it, and funding in President Donald Trump’s HIV plan, could do more harm than good if not distributed properly.

  August 9, 2019

  PrEP

  Bloomberg Law

Published Research

• Use of Intrauterine Devices and Risk of HIV Acquisition among Insured Women in the US

  Concerns have been raised about progestin-containing contraceptives and risk of HIV acquisition. Based on health insurance data from 622,565 women in the U.S. with intrauterine device (IUD) insertions during 2011-2018, there was no increased risk of incident HIV diagnosis among women using levonorgestrel-releasing IUDs compared with those using copper IUDs.

  August 15, 2019

  Hormonal Contraceptives and HIV

  Clinical Infectious Diseases

• Brief Report: HIV Antibodies Decline During Antiretroviral Therapy but Remain Correlated With HIV DNA and HIV-Specific T-Cell Responses

  In individuals on long-term ART, HIV-specific antibody and T-cell responses correlate with each other and with HIV DNA levels. The positive correlation between HIV immune responses and HIV DNA implies that the immune system is sensing, but not clearing, infected cells, perhaps because of immune dysfunction. Measuring immune responses to HIV antigens may provide insight into the impact of reservoir-reducing strategies.

  August 15, 2019

  Antibody Related Research, Treatment

  JAIDS

• Medicaid Expansion, HIV Testing, and HIV-Related Risk Behaviors in the United States, 2010–2017

  Medicaid expansion promoted HIV testing without increasing HIV risk behavior, but there were large disparities across race/ethnicity, age, and geographic area types. Nonexpansion states, mostly in the South, might have missed an opportunity to increase HIV test rates, which could have serious future health and financial consequences.

  August 15, 2019

  General

  AJPH

• Prioritizing HIV/AIDS Prevention Strategies in Bandung, Indonesia: A Cost Analysis of Three Different HIV/AIDS Interventions

  Indonesia has one of the fastest growing HIV epidemics in Asia, which mainly concentrates within risk groups. This study provides valuable insights in the costs of outreach to MSM and transgender, Harm Reduction Community Meetings (HRCMs) for Injecting Drug Users (IDUs) and Information, Education and Communication (IEC) at Maternal & Child Health Posts (MCHPs). Policy makers can use these results in setting priorities within Indonesia. Data on effectiveness of interventions is necessary to make conclusive statements regarding cost-effectiveness and priority of interventions.

  August 15, 2019

  General

  PLoS One

• A Person-Centered Approach to HIV-Related Protective and Risk Factors for Young Black Men Who Have Sex with Men: Implications for Pre-exposure Prophylaxis and HIV Treatment as Prevention

  Given that unique risk profiles emerged that were differentially predicted by sociodemographic characteristics and HIV status, these findings have implications for tailoring interventions to the needs of different subgroups of YBMSM. Also, disempowering or risky sexual situations and relationships among YBMSM must be addressed.

  August 14, 2019

  PrEP

  AIDS and Behavior

• Correlates of HIV Infection in Adolescent Girls and Young Women in Lesotho: Results From a Population-Based Survey

  The findings confirm the importance of improving the treatment cascade in male partners and targeting preventive interventions to AGYW who are at increased risk. A regional approach to prevention could mitigate the effect of migration on transnational spread of HIV.

  August 14, 2019

  General

  Lancet HIV

• Acceptability and Feasibility of a Pharmacist-Led HIV Pre-Exposure Prophylaxis (PrEP) Program in the Midwestern United States

  To date, no participant has seroconverted. One hundred percent of the participants who completed the patient satisfaction questionnaire would recommend the P-PrEP program. Pharmacists reported feeling comfortable performing point-of-care testing and rarely reported feeling uncomfortable during PrEP visits or experiencing workflow disruption. Implementation of a pharmacist-led PrEP program is feasible and associated with high rates of patient satisfaction and pharmacist acceptability.

  August 14, 2019

  PrEP

  Open Forum Infectious Diseases

• Antiretroviral Treatment, Government Policy and Economy of HIV/AIDS in Brazil: Is It Time for HIV Cure in the Country?

  Brazil is among the leading LMIC towards achieving the 90-90-90 UNAIDS goals in the years to come. In this review, we analyze Brazil’s progress throughout the HIV/AIDS epidemic to achieve state-of-the-art ARV treatment and to reduce AIDS mortality in the country. The top-quality HIV/AIDS research in Brazil towards HIV prophylactic and functional cure, the next step towards the economic sustainability of the battle against HIV, is also discussed.

  August 14, 2019

  Cure, PrEP, Treatment

  AIDS Research and Therapy

• Activation of Latent HIV-1 T Cell Reservoirs With a Combination of Innate Immune and Epigenetic Regulators

  Collectively, these results represent a promising step towards HIV eradication by demonstrating the potential of innate immune activation and epigenetic modulation to reduce the viral reservoir and induce specific death of HIV-infected cells.

  August 14, 2019

  HIV Vaccine

  Journal of Virology

• HIV Voluntary Counselling and Testing and Behaviour Changes Among Youths in Nigeria

  The attitudes of most Nigerian youths towards voluntary HIV counselling and testing needs to be improved through socioeconomic factors for healthy sexual activity. To achieve this, government and non-governmental organizations, as well as religious leaders and policymakers, should engage in appropriate and long-term activities directed at the sexual health needs of never-married youths, through voluntary HIV counselling and testing, to encourage them to change their sexual behaviour.

  August 14, 2019

  General

  Journal of Biosocial Science

• Vaccination of Macaques With DNA Followed by Adenoviral Vectors Encoding SIV Gag Alone Delays Infection by Repeated Mucosal Challenge With SIV

  These findings suggest that a non-persistent viral vector vaccine coding for internal virus proteins may be able to protect against HIV-1 infection. The mechanisms are probably distinct from antibody-mediated virus neutralization or cytotoxic CD8 cell killing of virus infected cells and may be mediated in part by CD4 T cells.

  August 14, 2019

  HIV Vaccine

  Journal of Virology

• Nanocrystal Formulation Improves Vaginal Delivery of CSIC for HIV Prevention

  5-Chloro-3-phenylsulfonylindole-2-carboxamide (CSIC) is a highly potent non-nucleoside reverse transcriptase inhibitor (NNRTI) with potential for use in topical prophylaxis against HIV transmission. However, the hydrophobic nature of CSIC limits its administration through vaginal route. In this study, we developed nanocrystals of CSIC to potentially improve the aqueous solubility and intracellular uptake of CSIC in vitro and in vivo.

  August 13, 2019

  Microbicides

  AAPS PharmSciTech

• Estimating the Size of Key Populations in Kampala, Uganda: 3-Source Capture-Recapture Study

  Our population size estimates for PWID, MSM, and FSW in Kampala provide critical population denominator data to inform HIV prevention and treatment programs. The 3-source capture-recapture is a feasible method to advance key population size estimation.

  August 12, 2019

  General

  JMIR Public Health Surveillance

• Social Harms in Female-Initiated HIV Prevention Method Research: State of the Evidence

  Measurement and screening for SH is an important component of conducting ethical research of novel HIV prevention methods. To date SH incidence reported in microbicide trials has been relatively low, and the majority have been partner-related events. However, any incidence of SH within the context of HIV prevention is important to capture and understand for the safety of individual women, and for the successful impact of prevention methods in a real-world context.

  August 12, 2019

  General

  AIDS

• Reaching the Second 90: The Strategies for Linkage to Care and Antiretroviral Therapy Initiation

  Progress towards meeting the 90–90–90 benchmarks has left gaps in linkage to care that require care-system development to facilitate increased access to care under universal test and treat (UTT) policies. Most notably, new strategies will need to focus on addressing the distinct needs of key populations and bolstering linkage to care from community-based and self-testing services.

  August 12, 2019

  Treatment

  Current Opinion in HIV and AIDS

• Competing Biomedical HIV Prevention Strategies: Potential Cost-Effectiveness of HIV Vaccines and PrEP in Seattle, Wa

  Access to an HIV vaccine is desirable as it could increase the overall effectiveness of combination HIV prevention efforts and improve population health. Planning for the rollout and scale‐up of HIV vaccines should carefully consider the design of policies that guide interactions between vaccine and PrEP utilization and potential competition.

  August 11, 2019

  HIV Vaccine, PrEP

  JIAS

• USP49 Potently Stabilizes APOBEC3G Protein by Removing Ubiquitin and Inhibits HIV-1 Replication

  Here, we found that USP49 directly interacts with A3G and efficiently removes ubiquitin, consequently increasing A3G protein expression and significantly enhancing its anti-HIV-1 activity. Unexpectedly, A3G degradation was also mediated by a Vif- and cullin-ring-independent pathway, which was effectively counteracted by USP49. Furthermore, clinical data suggested that USP49 is correlated with A3G protein expression and hypermutations in Vif-positive proviruses, and inversely with the intact provirus ratio in the HIV-1 latent reservoir.

  August 9, 2019

  Cure, Treatment

  eLife

• Exploration of HIV-1 Fusion Peptide–Antibody VRC34.01 Binding Reveals Fundamental Neutralization Sites

  Antibody binding to a vulnerable site of HIV envelope glycoprotein (Env), the eight N-terminal residues of the gp41 fusion peptide, renders robust HIV neutralization. Here, we theoretically investigate HIV-1 fusion peptide binding to the neutralizing antibody N123–VRC34.01. We explore numerous fusion peptide mutations using all-atom molecular dynamics simulation with explicit-solvent models. Our findings provide new insights into fusion peptide–VRC34.01 binding, which can ultimately be utilized to design effective HIV vaccines.

  August 8, 2019

  HIV Vaccine

  Physical Chemistry Chemical Physics

• The Role of Biomedical Interventions in HIV Prevention: Pre-Exposure Prophylaxis (PrEP)

  Currently, it has been extensively documented that the administration of antiretroviral treatment in an HIV exposed, but not infected population, could reduce the risk of transmission without significant drawbacks. Despite its high efficacy for HIV prevention, the use of PrEP remains a controversial measure, particularly its cost-effectiveness. For this reason, the access to PrEP is not available for all the HIV risk groups. Therefore, and based on the evidence found, the current approach must be the repercussions of not to implement PrEP, more than its cost or its effectiveness.

  August 5, 2019

  PrEP

  Medicina de Familia

• Adherence to PrEP Among Young Men Who Have Sex With Men Participating in a Sexual Health Services Demonstration Project in Alameda County, California

  Most young men who initiate PrEP adhere at levels that confer protection against HIV infection. Interventions should account for differences in life experiences, particularly addressing the structural challenges facing young African American men.

  August 1, 2019

  PrEP

  JAIDS

• Learning From the Exceptions: HIV Remission in Post-treatment Controllers

  In this review, we summarize the results of both clinical and basic research studies of post-treatment controllers (PTCs) to date, explore key differences between PTCs and HIV spontaneous controllers, examine potential mechanisms of post-treatment control, and discuss unanswered questions and future research directions in this field.

  July 24, 2019

  Treatment

  Frontiers In Immunology

• Implementation of Pre-Exposure Prophylaxis at a Community Pharmacy Through a Collaborative Practice Agreement With San Francisco Department of Public Health

  Implementation of a CPA between a community pharmacy and a local health department enabled the launch of pharmacist-delivered PrEP, further expanding the landscape of access points to vulnerable populations in San Francisco.

  July 3, 2019

  PrEP

  JAPhA

Announcements